MEDICARE: GAYATRI KAPUR MD

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207V00000X	Obstetrics & Gynecology Physician	0101230621	VA

General Provider Information

NPI Number	:	1639144926
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	GAYATRI KAPUR MD

Provider Business Mailing Address
First Line	:	PO BOX 936
Second Line	:
City	:	NORFOLK
State	:	VA
Zip	:	23501-0936
Country	:	US
Telephone Number	:	757-446-7900
Fax Number	:	757-446-8907

Provider Business Practice Location Address
First Line	:	2075 GLENN MITCHELL DR STE 500
Second Line	:
City	:	VIRGINIA BEACH
State	:	VA
Zip	:	23456-0179
Country	:	US
Telephone Number	:	757-446-7900
Fax Number	:	757-446-8907

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	02/21/2006
Last Update Date	:	10/09/2019

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